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It is not surprising, therefore, that erythromycin is associated with marked acceleration or dumping of food from the stomach since, as a motilin receptor agonist and stimulant of cholinergic mechanisms, it enhances both fundic contraction as well as antral motor function, thereby having a dual effect on mechanisms associated with increased longitudinal axial forces in the antrum in healthy participants and patients with dysmotilities and acceleration of gastric emptying (Surrenti et al., 1996

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For IBS, leaky gut, or inflammatory bowel conditions, the oral or sublingual troche is the first-choice route